论文部分内容阅读
目的:对比研究血清HTg的变化与131I全身显像在分化型甲状腺癌131I治疗随访的临床价值。方法:192例分化型甲癌患者,每位患者均为手术后接受(3~7)次的131I治疗,每次剂量(50~250)mCi,每次治疗前测定血清HTg,治疗后5d后进行前、后位全身显像。结果:192例接受131I去除术后残留甲状腺组织患者,HTg测试和131I全身显像人次各为825次。其中有125例患者HTg与131I全身显像均异常,有12例131I全身显像异常而HTg正常;有35例131I全身显像正常而HTg异常;有20例两者均正常。在47例结果不一致的患者中,其他影像证实12例131I全身显像异常患者有5例异常,而35例131I全身显像正常而HTg异常患者,有27例异常。结果显示HTg血清测定诊断分化型甲状腺癌转移的灵敏度和特异性分别为83%和97%,而131I全身显像的诊断灵敏度和特异性分别为72%和83%。结论:在分化型甲状腺癌131I治疗随访中,血清HTg的检测较131I全身显像更易发现甲状腺癌转移病灶,故前者有利于分化型甲癌患者随访及诊疗计划的安排。
Objective: To compare the changes of serum HTg with the clinical value of 131I whole body imaging in follow-up of 131I treatment of differentiated thyroid carcinoma. Methods: One hundred and ninety - two patients with differentiated A - type carcinoma were treated with 131I (3-7) 131I after operation. Each dose (50 ~ 250) mCi, serum HTg before each treatment, after 5 days Before and after the whole body imaging. Results: Of the 192 patients with residual thyroid tissue who underwent 131I removal, the number of HTg tests and 131I whole body imaging were 825. There were 125 cases of HTg and 131I whole body imaging were abnormal, 12 cases of 131I whole body imaging abnormalities and HTg normal; 35 cases of 131I whole body imaging was normal and HTg abnormalities; 20 cases were both normal. Of the 47 patients with inconsistent results, other images confirmed abnormalities in 12 patients with 131I total body imaging abnormalities, whereas 35 patients with 131I total body imaging normal and HTg abnormalities had 27 abnormalities. The results showed that the sensitivity and specificity of the HTg serodiagnosis in diagnosing differentiated thyroid cancer were 83% and 97%, respectively, whereas the diagnostic sensitivity and specificity of 131I whole body imaging were 72% and 83%, respectively. Conclusion: In the follow-up of 131I treatment of differentiated thyroid cancer, the detection of serum HTg is more susceptible to thyroid cancer metastasis than 131I whole body imaging. Therefore, the former is beneficial to the follow-up of patients with differentiated thyroid cancer and the planning of diagnosis and treatment.